Evidence suggests that poor communication with providers and problematic client-provider relationships among racial and ethnic minorities are associated with disparities in health care. The long -term objectives are to improve the quality of prenatal care, specifically for African American (AA) women through improving client-provider communication and ultimately to reduce racial/ethnic disparities in pregnancy outcomes. The purpose of this exploratory, descriptive, cross-sectional study is to describe client-provider interaction and its influence on African American (AA) women's satisfaction with prenatal care. In this study, we will recruit 18- 35 year old AA women (N=130) who are in their first trimester and their female providers, OB/GYN or advanced practice nurse providers, (N=10-12) from prenatal care clinics at two tertiary care, urban hospitals in Southeastern Michigan. Client-provider interaction will be described using two different methods, audio recordings and post-visit questionnaires. The modified version of Interaction Model of Client Health Behavior (IMCHB) will be used as the framework for this study. We will address three Specific Aims: 1). Describe client-provider interaction (affective support, health information, decisional control, and discrimination) among AA women and providers during the initial prenatal care visit; 2). Examine whether client-provider interaction predicts AA women's satisfaction with prenatal care 3). Compare differences and similarities in client-provider interaction when providers are racially concordant and discordant with AA women. This study is foundational to the development of interventions that will improve client-provider communication, enhance both satisfaction with and quality of prenatal care, and ultimately reduce healthcare disparities for African American pregnant women. The impact of quality client-provider communication in improving quality of care and the health status of individuals is recognized in Healthy People 2010. Specific recommendations include improving provider- client relationships through effective communication skills training and increasing the proportion of clients who are satisfied with their providers' communication skills. In addition, this research addresses NINR scientific goals of reducing health disparities and improving quality of care, and is congruent with the mission of AHRQ which includes improving the outcomes and quality of health care. [unreadable] [unreadable] [unreadable]